Journal of Palliative Care & Medicine 

About: Journal of Palliative Care & Medicine is an academic journal. The journal publishes majorly in the area(s): Palliative care & Cancer. It has an ISSN identifier of 2165-7386. It is also open access. Over the lifetime, 314 publications have been published receiving 999 citations.

Toward an Interprofessional Mentoring Program in Palliative Care - A Review of Undergraduate and Postgraduate Mentoring in Medicine, Nursing, Surgery and Social Work

Abstract: Objective: Key to effective Palliative Care is interdisciplinary collaboration and holistic support of members of the multidisciplinary team. Mentoring is increasingly seen as being a critical facet of this process however; there is a dearth of guidance on establishing such a program within the Palliative Care setting. To fill this gap, this review analyzes mentoring programs in medicine, surgery, nursing and social work in order to identify key elements and common facets of successful mentoring programs that can be used to create a multi-professional mentoring program in Palliative Care. Methods: A review of systematic review of undergraduate and postgraduate mentoring programs in medicine, surgery, nursing and social work involving senior clinicians and junior doctors and/or medical students. Results: A total of 20 reviews were included. One review was on mentoring in medicine and nursing, 10 in medicine, 4 in surgery and 5 in nursing. There were no reviews of mentoring in social work. Thematic analysis revealed 3 themes, which were definition of mentoring, components of a mentoring approach and elements of the mentoring process Conclusion: Despite its context sensitive, goal specific and mentee- and mentor- dependent features, common features in mentoring in medicine, surgery and nursing lay the foundation for a learning theory of interprofessional mentoring that can guide construct effective mentorship programs.

Creating Effective Interprofessional Mentoring Relationships in Palliative Care-Lessons from Medicine, Nursing, Surgery and Social Work

Abstract: Palliative Care requires multidisciplinary teamwork to achieve its patient specific objectives. Success of this approach pivots on nurturing effective interprofessional relationships through the provision of holistic support and multidimensional training of multiprofessional Palliative Care team members. Mentoring is seen as an effective means of facilitating multiprofessional collaborations however little data exists on operationalizing an interprofessional mentoring program in Palliative Care. To address this gap and circumnavigate the context-specific nature of mentoring, we scrutinized mentoring approaches in medicine, surgery, nursing and medical social work to identify common elements of mentoring within their respective practices that will provide the basis of an interprofessional mentoring in Palliative Care. Thematic analysis of 20 reviews of undergraduate and postgraduate mentoring programs in medicine, surgery and nursing suggest that successful mentoring programs are underscored by effective nurturing and support of mentoring relationships. Successful mentoring relationships are built on strong relational ties between mentees and mentors. Delineating the key elements to effective mentoring relationships allow for the forwarding of a basic framework to enhance relational ties within interdisciplinary mentoring in Palliative Care and the proffering of an evidence-based platform for the adoption of a cognitive apprenticeship model that can guide the operationalization of a multiprofessional mentoring program in Palliative Care.

Towards a Practice Guided Evidence Based Theory of Mentoring in Palliative Care

Abstract: Provision of end of life care and coping with the emotional and existential distress engendered by palliative care demands the provision of holistic support and training for palliativists. Mentoring is an effective means of meeting this need; however little is known of mentoring in palliative care and a universally accepted learning theory of mentoring remains lacking in this setting. To advance mentoring practice in palliative care, we review the only two evidenced based mentoring theories based upon narrative reviews of mentoring practice in the key specialties within palliative care teams. Building upon mentoring’s mentee, mentor and organizational dependent, goal specific, context sensitive features highlighted in both recent reviews of mentoring this paper proffers a working theory of mentoring. Constructed Krishna’s Mentoring Pyramid that underlines the 5 core elements of successful mentoring programs, we propose melding elements of the cognitive apprenticeship model with the adult learning theory using the multi-theories model of adult learning offers an effective starting point for a mentoring theory. More context-specific studies are needed to provide better insight into the validity of this framework in the ongoing pursuit of an interprofessional mentoring theory in Palliative Medicine.

The Development and Validation of a Questionnaire to Audit Advance Care Planning

Abstract: Background: Advance Care Planning (ACP) is established as a standard of care in many settings. However, no validated tool exists to measure participants’ perspectives on ACP. The purpose of this study was to develop and validate a questionnaire to assess ACP from the perspectives of patients and their family members, and to pilot the use of this questionnaire in both English and French. Methods: To develop the ACP-specific questionnaire, items were generated from focus groups with health care professionals and face-to-face interviews withhospitalized patients and their families. The items from this novel questionnaire were combined with other validated evaluation instruments and then piloted in English-speaking hospitalized patients who had advanced, life-limiting illnesses and a version for their family members. Revisions were made based on that experience and feedback from content experts and this questionnaire was then piloted in another sample of French-speaking respondents. Results: The novel questionnaire was divided into 2 parts, the first part focusing on ACP activities before admission to hospital (6 questions) and the second part relating to ‘goals of care’ discussions that occur during hospitalization (8 questions). For the English pilot study, the average duration of the entire interview (including consent, baseline demographics and other questionnaires) was 53.1 mins (range 35-80 mins) for patients and 60.8 mins (range 33-125 mins) for family members. English-speaking patients rated the burden of participating in the interview as a mean of 2.8 (Standard Deviation [SD] 1.9, 1=no burden, 10=extreme burden) and family members as 1.9 (SD 1.9). For the French pilot study, the results were similar. Conclusions: This is the first ACP questionnaire to be developed that has face and content validity. Despite a relatively lengthy interview process, the ACP audit process seems feasible and is not associated with undue burden.

Barriers and Facilitators to Chronic Non-cancer Pain Management in Primary Care: A Qualitative Analysis of Primary Care Providers' Experiences and Attitudes

Abstract: Objectives: Most patients with chronic non-cancer pain (CNCP) are cared for, by primary care providers (PCPs). While some of the barriers faced by PCPs have been described, there is little information about PCPs’ experience with factors that facilitate CNCP care. Design: The study design was descriptive and qualitative. Data were analyzed using qualitative content analysis. Krippendorff’s thematic clustering technique was used to identify the repetitive themes regarding PCPs’ experiences related to CNCP management. Subjects: Respondents were PCPs (n=45) in the VA Connecticut Healthcare System in two academically affiliated institutions and six community based sites. Results: Eleven themes were identified across systems, personal/professional, and interpersonal domains. Barriers included inadequate training, organizational impediments, clinical quandaries and the frustrations that accompany them, issues related to share care among PCPs and specialists, antagonistic aspects of provider-patient interactions, skepticism, and time factors. Facilitators included the intellectual satisfaction of solving difficult diagnostic and management problems, the ability to develop keener communication skills, the rewards of healing and building therapeutic alliances with patients, universal protocols, and the availability of complementary and alternative medicine resources and multidisciplinary care. Conclusion: PCPs experience substantial difficulties in caring for patients with pain while acknowledging certain positive aspects. There is a need for strategies that mitigate the barriers to pain management while bolstering the positive aspects to improve care and provider satisfaction.